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Respiratory infections in children born preterm in low and middle-income countries: A systematic review

Shivashankar Diggikar1, Abhishek Paul2, Abdul Razak3,4

  • 1Department of Pediatrics, Oyster Woman and Child Speciality Hospital, Bengaluru, India.

Pediatric Pulmonology
|September 8, 2022
PubMed

Insights

Infants born preterm in low- and middle-income countries face a higher risk of respiratory infections, including respiratory syncytial virus (RSV). This underscores the need for targeted preventive strategies to protect vulnerable preterm infants.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Global Health

Background:

  • Limited data exist on respiratory infection risks for preterm infants in low- and middle-income countries (LMICs).
  • Preterm birth is a known risk factor for respiratory infections in high-income nations.
  • This review addresses the knowledge gap concerning respiratory health outcomes in preterm infants within LMICs.

Approach:

  • Systematic review of observational studies on respiratory outcomes in preterm children from LMICs.
  • Searched multiple databases including Medline, PubMed, CINAHL, Embase, and PsycINFO.
  • Data extraction and risk of bias assessment were performed independently by two authors.

Key Points:

  • Twelve studies involving 5969 children were analyzed.
  • Preterm infants showed a significantly higher risk of respiratory tract infections (RR 1.52) compared to term-born infants.
  • Reported risks for lower respiratory tract infection ranged from 5% to 73.9%, and respiratory syncytial virus (RSV) infection from 4.4% to 22.7%.

Conclusions:

  • Preterm-born children in LMICs experience a substantial, albeit variable, risk of increased respiratory infections.
  • The findings highlight the critical need for implementing preventive measures.
  • Respiratory syncytial virus (RSV) immunoprophylaxis is recommended as a key preventive strategy.
Abstract

Keywords:
LRTIbronchiolitislow birth weightpneumoniaprematurerespiratory syncytial virusventilation

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